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J. Biol. Chem., Vol. 279, Issue 17, 17996-18007, April 23, 2004
ACE2 X-Ray Structures Reveal a Large Hinge-bending Motion Important for Inhibitor Binding and Catalysis*![]() ![]() ¶![]() ![]() ![]() ![]() ![]() ![]() **
From the
Received for publication, October 10, 2003 , and in revised form, January 26, 2004.
The angiotensin-converting enzyme (ACE)-related carboxypeptidase, ACE2, is a type I integral membrane protein of 805 amino acids that contains one HEXXH + E zinc-binding consensus sequence. ACE2 has been implicated in the regulation of heart function and also as a functional receptor for the coronavirus that causes the severe acute respiratory syndrome (SARS). To gain further insights into this enzyme, the first crystal structures of the native and inhibitor-bound forms of the ACE2 extracellular domains were solved to 2.2- and 3.0-Å resolution, respectively. Comparison of these structures revealed a large inhibitor-dependent hinge-bending movement of one catalytic subdomain relative to the other ( 16°) that brings important residues into position for catalysis. The potent inhibitor MLN-4760 ((S,S)-2-{1-carboxy-2-[3-(3,5-dichlorobenzyl)-3H-imidazol4-yl]-ethylamino}-4-methylpentanoic acid) makes key binding interactions within the active site and offers insights regarding the action of residues involved in catalysis and substrate specificity. A few active site residue substitutions in ACE2 relative to ACE appear to eliminate the S2' substrate-binding subsite and account for the observed reactivity change from the peptidyl dipeptidase activity of ACE to the carboxypeptidase activity of ACE2.
The angiotensin-converting enzyme (ACE)1-related carboxypeptidase, ACE2, is a type I integral membrane protein of 805 amino acids that contains one HEXXH + E zinc-binding consensus sequence (1, 2). The catalytic domain of ACE2 is 42% identical to that of its closest homolog, somatic angiotensin-converting enzyme (sACE; EC 3.4.15.1 [EC] ), a peptidyl dipeptidase that plays an important role in the renin angiotensin system for blood pressure homeostasis. The loss of ACE2 in knockout mice has no effect on blood pressure, but reveals ACE2 as an essential regulator of heart function (3). In a recent discovery, ACE2 was identified as a functional receptor for the coronavirus that is linked to the severe acute respiratory syndrome (SARS) (4, 5).
The physiological differences observed in the phenotypes of ACE (6, 7) and/or ACE2 (3) knockout mice presumably reflect the significant differences in substrate specificity and reactivity between these enzymes. Many substrates for ACE2 were identified by screening biologically active peptides (8). In all cases, only carboxypeptidase activity was found. Of the seven best in vitro peptide substrates identified (kcat/Km > 105 M-1 s-1), proline and leucine are the preferred P1 residues, with a partiality for hydrophobic residues in the P1' position, although basic residues at P1' are also cleaved (peptide-binding subsites in proteins are as previously defined (9)). Some of the best in vitro peptide substrates are apelin-13, des-Arg9-bradykinin, angiotensin II, and dynorphin A-(1-13). The longest peptide substrate identified is a 36-residue peptide, apelin-36 (8). An examination of the ACE2 and ACE literature may be found in recently published reviews (10-12). We report here the first crystal structures of the extracellular metallopeptidase domain of ACE2 in its native and inhibitor-bound states and discuss the influence of these structures in understanding the substrate specificity and catalytic mechanism of the enzyme. While preparing these ACE2 structures for publication, two reports on the crystal structures of testicular angiotensin-converting enzyme (tACE) and Drosophila ACE appeared in the literature (13, 14).
Protein Expression and PurificationA truncated extracellular form of human ACE2 (residues 1-740) was expressed in baculovirus and purified as described previously (8). The signal sequence (residues 1-18) is presumably removed upon secretion from Sf9 cells. The molecular mass of the purified enzyme is 89.6 kDa by matrix-assisted laser desorption ionization time-of-flight mass spectrometry, which is greater than the theoretical molecular mass of 83.5 kDa expected from the sequence (residues 19-740). The difference of 6 kDa is believed to be due to glycosylation at the seven predicted N-linked glycosylation sites for this protein.
CrystallizationBriefly, 2 µl of purified ACE2 (5 mg/ml) was combined with an equal volume of reservoir solution, and crystals were grown by hanging drop vapor diffusion at 16-18 °C. The best crystallization reservoir solution conditions for native ACE2 were found to be 100 mM Tris-HCl (pH 8.5), 200 mM MgCl2, and 14% polyethylene glycol 8000. Under these conditions, it took
Data Collection and Structure DeterminationThe best data set for native ACE2 was at 2.2-Å resolution and was collected at the Advanced Photon Source (Argonne National Laboratory). A total of 44 x-ray data sets were collected for native ACE2, including a large number of heavy atom soaks of atoms that had good anomalous signals. The data sets for each derivative were collected at different wavelengths to maximize the anomalous signals for the bound heavy atoms. Native ACE2 data were collected to 2.2-Å resolution at The heavy atom positions were determined and confirmed by a combination of visual inspection of Patterson maps and automatic search procedures, which included SHAKE `N BAKE (16) and SHELXD (17). The heavy atom parameters were refined and optimized using the computer programs SHARP (18), MLPHARE (19), and XHEAVY (20). The experimental phases were improved by solvent flattening and histogram matching. Once the native ACE2 structure was determined, it was used to solve the inhibitor-bound structure of ACE2 to 3.0-Å resolution using molecular replacement methods that employed the program AMoRe in the CCP4 software suite (21). The native structure was split into two subdomains: subdomains I and II (see Fig. 3 for definition). Subdomain II was used for molecular replacement and refined in REFMAC5, which resulted in the appearance of electron density for subdomain I. Subdomain I was then fitted into the density by hand, and the structure was refined as a whole. Final refinement was accomplished using the software suite CNX (22).
Native ACE2 StructureThe three-dimensional structure of the extracellular region of native ACE2 was determined by multiple isomorphous replacement with anomalous scattering and refined to a crystallographic R-factor of 23.5% (Rfree = 28.7%) at 2.2-Å resolution. The heavy atom data statistics are summarized in Table I, and the refinement statistics for native ACE2 are summarized in Table II.
The extracellular region of the human ACE2 enzyme is composed of two domains. The first is a zinc metallopeptidase domain (residues 19-611), which is 42% identical to the corresponding domains of human sACE and tACE (Fig. 1). Electron density near the active site of native ACE2 is shown in Fig. 2a. An -carbon trace for this metallopeptidase domain of ACE2 is shown in Fig. 3A. The second domain is located at the C terminus (residues 612-740) and is 48% identical to human collectrin (23). Unfortunately, the electron density map for much of the collectrin homology domain is weak. Only half of this domain is visible in the electron density map, and what can be seen is ambiguous due to topology and connectivity issues.
The metallopeptidase domain of ACE2 can be further divided into two subdomains (I and II) (Fig. 3B), which form the two sides of a long and deep cleft with dimensions of 40 Å long by 15 Å wide by 25 Å deep. The two catalytic subdomains are connected only at the floor of the active site cleft. One prominent -helix (helix 17, residues 511-531) connects the two subdomains and forms part of the floor of the canyon. The deeply recessed and shielded proteolytic active site of ACE2 is a common structural feature of proteases and exists to avoid hydrolysis of correctly folded and functional proteins (24, 25) and is also consistent with the profiles of binding of tethered inhibitors to sACE (26, 27).
The N terminus-containing subdomain I and the C terminus-containing subdomain II are defined in Fig. 3B. This subdomain definition is based on the subdomain movement that was observed upon inhibitor binding (see below). The secondary structure of the metallopeptidase domain of ACE2 is composed of 20 The zinc-binding site is located near the bottom and on one side of the large active site cleft (subdomain I side), nearly midway along its length. The zinc is coordinated by His374, His378, Glu402, and one water molecule (in the native structure). These residues at the zinc-binding site of ACE2 make up the HEXXH + E motif conserved in the zinc metallopeptidase clan MA (28).
A chloride ion (Cl-) is bound in native ACE2, coordinated by Arg169, Trp477, and Lys481 in subdomain II. The larger electron density compared with water supports the assignment of this density to a Cl- ion, as does as the larger than expected distances between the coordinating side chains and the Cl- ion (compared with water H-bonds): N- Inhibitor-bound ACE2 StructureThe structure of ACE2 with an inhibitor bound at the active site was solved by molecular replacement to a resolution of 3.0 Å using the native ACE2 structure. Refinement statistics for the inhibitor-bound ACE2 structure are shown in Table II. The bound compound MLN-4760 potently inhibits human ACE2 (IC50 = 0.44 nM), but weakly inhibits tACE (IC50 > 100 µM) and carboxypeptidase A (IC50 = 27 µM) (15). The structure of the bound inhibitor is shown in Fig. 2b along with the experimental electron density map near the active site.
Ligand-dependent Subdomain Hinge-bending MovementThere is a clear difference between the native and inhibitor-bound ACE2 structures with respect to the distance separating the two subdomains (Fig. 4A). These two subdomains undergo a large inhibitor-dependent hinge-bending movement of one catalytic subdomain relative to the other (
The movement of residues within the active site is shown in Fig. 4B. This view is a close-up of Fig. 4A with subdomain II of the native and inhibitor-bound ACE2 structures superimposed. Many of these residues move as much as 6-9 Å after binding of the inhibitor. Similar subdomain hinge-bending motions have also been observed for other zinc metalloproteases (29, 30). The largest previously observed ligand-dependent movement for metalloproteases is a 14° hinge-bending subdomain motion demonstrated for Pseudomonas aeruginosa elastase (open versus closed) that resulted in an 2-Å movement to close the N-terminal/C-terminal subdomain gap (29). Domain closure movements in proteins are a common mechanism for the positioning of critical groups around substrates and inhibitors (31-33) and also for the trapping of substrate and reaction intermediates (34).
Inhibitor Binding Interactions and Implications for Substrate Specificity and CatalysisBoth metallopeptidase subdomains of ACE2 are nearly equally involved in binding of the inhibitor MLN-4760. Inspection of the interactions between MLN-4760 and ACE2 revealed important residues responsible for inhibitor binding and presumably for substrate binding and catalysis (Fig. 5). The inhibitor MLN-4760 has two carboxylate groups, one of which binds to the zinc atom by displacing the bound water molecule present in the native ACE2 structure. The zinc coordination sphere (His374, His378, and Glu402) is a subset of the 21 residues of ACE2 that are located within 4.5 Å of the bound inhibitor and that make up the greater part of the active site. Six of the most important of these residues contribute specific H-bonding interactions with MLN-4760 (Fig. 5). The side chains of Arg273, His505, and His345 are H-bonded to the terminal carboxylate of the inhibitor. The carbonyl oxygen atom of Pro346 and the N-
The zinc-bound carboxylate of MLN-4760 appears to mimic the zinc-bound tetrahedral intermediate characteristic of nucleophilic attack of the scissile bond by the zinc-bound water during peptide hydrolysis (35). This transition state structure is usually stabilized by H-bonds donated by imidazole, phenolic, or guanidino functional groups of neighboring amino acid side chains in other zinc metalloproteases (30, 35). For ACE2, this carboxyl anion stabilization most likely occurs through the phenolic group of Tyr515 (Fig. 5). Besides the zinc coordination sphere and potential H-bond-contributing residues, there are an additional 11 residues of ACE2 that make close contacts (<4.5 Å) with MLN-4760, many of which are shown in Fig. 5. These residues do not contribute direct H-bonding interactions with the inhibitor, but provide important electrostatic and van der Waals interactions with MLN-4760. These residues define the S1 and S1' peptide-binding subsites, thereby providing the inhibitor, as well as substrate, binding specificity. The isobutyl group of MLN-4760 packs nicely into the S1 subsite of ACE2 (Fig. 5A), suggesting a similar preferred fit for a leucyl side chain at the P1 position of peptide substrates. The topology and chemical environment of the S1 subsite are dictated by four residues (Tyr510, Arg514, Phe504, and Thr347) that are expected to restrict the size of substrate P1 side chains. Large substrate P1 residues such as Trp, Tyr, Phe, Arg, and Lys would require significant movement of the phenolic side chain of Tyr510, which forms a lid over the top of the S1 subsite. This observation is consistent with the reported substrate specificity data showing only medium sized residues (Pro and Leu) at the P1 position for preferred substrates with kcat/Km > 105 M-1 s-1 (8). Peptides with Phe and Tyr at the P1 position, such as angiotensin-(1-9) (DRVYIHPFH), bradykinin (RPPGFSPFR), Leu-enkephalin (YGGFL), Met-enkephalin (YGGFM), and angiotensin-(1-5) (DRVYI), are not substrates for ACE2 despite the presence of preferred hydrophobic or basic P1' residues. Some ACE2-catalyzed hydrolysis was observed for peptides with a slightly larger residue (His) at the P1 site (i.e. angiotensin I), but the catalytic efficiency was orders of magnitude lower (kcat/Km = 4.9 x 103 M-1 s-1) despite good binding. The limited size of the S1 subsite may also account for the observed orientation of binding of MLN-4760. The design principles leading to the identification of MLN-4760 were based on assumptions from substrate screening studies and information regarding known metallopeptidase inhibitors (36). Consequently, MLN-4760 was designed as a His-Leu mimetic, in which the isobutyl side chain was predicted to mimic the Leu side chain (P1'), and the substituted His was expected to bind in the S1-S2 subsites (15). Furthermore, the Leu carboxylate was envisioned to mimic the substrate's C-terminal carboxylate, and the His carboxylate was expected to coordinate the zinc atom. Although the inhibitor potency optimization was supported by this design hypothesis (several selective inhibitors at <10 nM), experimentally, the inhibitor-bound crystal structure reveals that MNL-4760 binds in the opposite orientation: the two carboxylates are reversed, the isobutyl side chain occupies the S1 subsite, and the 3,5-dichlorobenzylimidazole group binds in the S1' subsite. This alternative binding mode may be the result of the small S1 subsite, which cannot accommodate the 3,5-dichlorobenzyl group. Models of MLN-4760 bound to ACE2 that were based on the tACE structure (37) did not predict the observed binding mode shown in Fig. 5. Retrospective comparison of the inhibitor structure-activity relationship with the crystal structure supports the unanticipated binding orientation. During the potency optimization studies, it appeared that the His portion of the inhibitors better tolerated changes in size and physicochemical properties compared with the Leu portion, which is consistent with the new experimental evidence (Fig. 5). The S1' subsite of ACE2 is much larger than the S1 subsite and is formed by the lengthwise channel between the two subdomains. In addition to the aforementioned residues that contribute specific H-bonding interactions with MLN-4760 (Arg273, His345, His505, Thr371, and the carbonyl group of Pro346), there are a number of other residues that make close contacts with the 3,5-dichlorobenzylimidazole group of the inhibitor. The side chains of Phe274, Pro346, Thr371, Met360 and the disulfide linkage of Cys344 and Cys361 provide a hydrophobic environment for the S1' subsite. Additional close contacts are observed for the side chains of Asp368, Glu145, Asn149, and Lys363 and the carbonyl groups of Cys344 and Cys361, which accommodate the far end of the dichlorobenzyl ring as depicted in Fig. 5B. The large size of the this S1' subsite easily accommodates the 3,5-dichlorobenzylimidazole group of MLN-4760 and mirrors the observed preference for large hydrophobic or basic residues (Arg and Lys) at the P1' position of peptide substrates (8).
Comparison with Structural HomologsThere are four proteins in the Protein Data Bank (38) that have overall architectural similarity to ACE2. They include the following: 1) the recently solved human tACE (code 1O86
[PDB]
) (13), an enzyme of the M2 metallopeptidase family (EC 3.4.15.1
[EC]
); 2) Drosophila ACE (code 1J36
[PDB]
), with which ACE2 shares
Comparison with tACEThe
An improved superposition of the inhibitor-bound ACE2 and tACE structures (r.m.s. deviation of 0.53 Å) was obtained by considering just the equivalent -carbon atoms of the aforementioned 21 residues of ACE2 that come within 4.5 Å of the bound MLN-4760 (Fig. 6B). Thirteen of these active site residues are conserved in the tACE and sACE enzymes: Glu145, Cys344, His345, Cys361, Asp368, His374, Glu375, His378, Glu402, Phe504, His505, Arg514, and Tyr515. These structural similarities reflect the nearly identical way that MLN-4760 and lisinopril sit in the superimposed active sites (Fig. 6B).
The remaining eight active site ACE2 residues are substituted in tACE as follows: Asn149
Another important difference between ACE2 and tACE is the Arg273 The native tACE structure was reported to be nearly identical to the lisinopril-bound tACE structure (13), suggesting that no ligand-dependent conformational change occurs for tACE or at least under the conditions used to obtain these crystals (pH 4.7, 50 mM sodium acetate with an unspecified [Cl-]) (41). However, inspection of the reported native tACE structure (Protein Data Bank code 1O8A [PDB] ) reveals that two ligands are bound to the active site: an acetate molecule bound to the zinc atom and an unknown compound that presumably originated during protein expression and purification. This compound was modeled as an N-carboxyalanine and is isosteric with 2-methylsuccinic acid according to notes deposited with the native tACE coordinates in the Protein Data Bank file. This 2-methylsuccinate-like ligand is bound to tACE in a manner that closely resembles that observed for lisinopril. Five of the same H-bonds present in the lisinopril-bound tACE structure are also present for the 2-methylsuccinate-like ligand. Therefore, the reported native tACE structure would appear to be another ligand-bound structure, and its closed conformational state is consistent with other ligand-bound tACE and ACE2 structures.
Structural Homology for the Catalytic MotifACE2 and related ACE enzymes are related to other HEXXH clan members through divergent evolution with an overall primary sequence identity that is <15% (Fig. 7A). The two largest metallopeptidase clans are clan MA (gluzincin family) and clan MB, which include the many families of zinc metallopeptidases that have the HEXXH + E and HEXXH + H zinc-binding motifs, respectively (28). Among these clans, there is structural homology for the catalytic motif and the core of the inhibitor/substrate-binding site. Representative examples of the catalytic motifs of some members of these clans are shown in Fig. 7B. These active sites include thermolysin (clan MA) and astacin (clan MB) in complex with transition state analogs (30, 42). The ACE2 complex with MLN-4760 is shown for comparison. These transition state analogs bind to thermolysin and astacin in a manner that is similar to the way MLN-4760 binds to ACE2 and reveal a high level of structural homology between the catalytic motifs of these enzymes. Indeed, eight
Proposed Catalytic Mechanism for ACE2-mediated Peptide HydrolysisThe strong structural homology of the active site of inhibitor-bound ACE2 to catalytic motifs of evolutionarily related enzymes in metallopeptidase clans MA and MB (Fig. 7) suggests that many of these structural elements play similar catalytic roles in ACE2. These similarities have led to a proposed catalytic mechanism for ACE2 (Fig. 8) that has many features in common with mechanisms proposed for other HEXXH zinc metallopeptidase clan members (30, 35, 40). The mechanism reveals a probable initial ES complex formation and generation of the tetrahedral intermediate. The formation of this ES complex causes an 16° subdomain hinge-bending movement of subdomain I toward subdomain II, bringing all the catalytic components into a functional orientation. These substrate and inhibitor-dependent subdomain movements are consistent with induced fit and transition state theories of catalysis (43).
Other metallopeptidases exhibit hinge-bending motions upon ligand binding (see above), but the average ligand-dependent displacements of 6-9 Å for residues at the active site of ACE2 (Fig. 4B) are much larger than previously reported displacements ( 2 Å) (29). These relative movements at the active site of metallopeptidases are a function of the hinge-bending angle and also the size of the opposing subdomains. Another distinguishing feature of this mechanism is the proton transfer from His505 to the leaving nitrogen atom of the P1' residue. A protonated histidine is supported by the pH-rate profile that has a maximum at 6.5 (8). Additional evidence for the role for His505 comes from site-directed mutagenesis in sACE, where mutation of the analogous His1089 to Ala results in a 100-fold drop in kcat and 4.5-fold drop in Km (44). Similarly, the His1089 Leu mutation results in a 671-fold drop in kcat and a 6.2-fold drop in Km. The much larger impact on kcat compared with Km supports a catalytic role for this histidine rather than an important binding function (44). His505 appears to be too far from the zinc-bound carboxylate (6.3 Å) to be directly involved in H-bonding stabilization of the carbonyl tetrahedral intermediate, as was expected from sequence homology (44). Protonation and stabilization of the sp3 hybridized nitrogen of the peptide intermediate as depicted in Fig. 8 may better explain the site-directed mutagenesis data. Many elements of this mechanism are believed to be relevant to tACE and sACE as well, except with release of dipeptide products due to the larger, more accommodating S2' subsite in ACE.
Anion-binding SitesAn interesting aspect of the ACE2-mediated substrate hydrolysis is the activation by chloride ions and other anions (8) in much the same way that anions activate substrate hydrolysis and inhibitor binding for sACE and tACE (45, 46). A single bound chloride ion was identified in the high resolution native ACE2 structure (Fig. 3). The location of this anion-binding site in subdomain II is nearly identical to the position of a chloride ion in the tACE structure, which was designated CL1 (13). The chloride-coordinating ligands Arg169, Trp477, and Lys481 correspond to Arg186, Trp485, and Arg489, respectively, in tACE. In ACE2, this anion-binding site is With only a single common anion-binding site observed for ACE2 and tACE (CL1), it is possible to imagine that this site is responsible for the anion activation effect in both homologous enzymes. On the other hand, site-directed mutagenesis studies suggest that the Cl--coordinating ligand Arg1098 of sACE (Arg522 of tACE) at the second chloride ion site in tACE (CL2) plays a role in anion activation in sACE (47). The equivalent residue in ACE2 (Arg514) cannot play the same role because this chloride-binding site is replaced in ACE2 with the Glu398/Ser511 double substitution. A simple explanation for the experimentally observed anion activation in ACE2 is that a second chloride ion site exists in substrate- or inhibitor-bound ACE2, but at a different location than observed for tACE. This second anion-binding site, specific to the inhibitor-bound form of the enzyme, may help to shift the open/closed conformational equilibrium in favor of the closed or catalytic competent closed conformer, thus ensuring a tighter grasp on the transition state for peptide hydrolysis. Kinetic models for the effect of anions on the activity and inhibition of sACE (45, 46) are consistent with chloride ions influencing catalysis through shifts in conformer equilibria. Unfortunately, the lower resolution of the MLN-4760-bound ACE2 structure (3.0 Å) limits the distinction between chloride ions and water molecules in this model. One or more of the 13 water molecules modeled into the inhibitor-bound ACE2 structure could be additional bound chloride ions, but higher resolution data are needed to confirm. Similarly, it is not known whether the second chloride ion of tACE (CL2) is unique to inhibitor-bound tACE and not bound in native tACE because no true native tACE structure is currently available. ACE2 as the SARS Coronavirus ReceptorThe recent identification of ACE2 as a functional receptor for the SARS coronavirus (4, 5) has raised questions about what binding determinants on ACE2 interact with the virus. Mutations of the ACE2 zinc-coordinating residues His374 and His378 to asparagines were found to have no effect on syncytial formation (4), suggesting that interfering with the active site has no effect on viral spike protein binding to ACE2. However, the large conformational change observed upon MLN-4760 binding to ACE2 could prove to be unfavorable for viral binding to its receptor and/or syncytial formation. Thus, metallopeptidase inhibitors such as MLN-4760 may still prove useful for prevention of viral binding to ACE2 and blockage of infection. The ACE2 structures reported here are expected to be useful in aiding efforts to identify the binding site for the SARS coronavirus spike protein. Moreover, the x-ray structures should enable the future design of more potent and specific inhibitors of ACE2, at either the metallopeptidase site or any separate viral spike protein-binding exosite that may be discovered.
The atomic coordinates and structure factors (code 1R42 [PDB] and 1R4L [PDB] ) have been deposited in the Protein Data Bank, Research Collaboratory for Structural Bioinformatics, Rutgers University, New Brunswick, NJ (http://www.rcsb.org/).
* The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
¶ Present address: Syrrx Inc., San Diego, CA 92121. ** To whom correspondence should be addressed: Millennium Pharmaceuticals, Inc., 270 Albany St., Cambridge, MA 02139. Tel.: 617-551-8677; Fax: 617-551-7919; E-mail: pantoliano{at}mpi.com.
1 The abbreviations used are: ACE, angiotensin-converting enzyme; sACE, somatic angiotensin-converting enzyme; tACE, testicular or germinal angiotensin-converting enzyme; SARS, severe acute respiratory syndrome; r.m.s., root mean square; Z, benzyloxycarbonyl.
We thank Rebecca Matthew and Geoff Stamper for help with the characterization of early ACE2 crystals and Larry Dick, Paul Hales, Chad Vickers, Peter Tummino, Mary Donoghue, and Susan Acton for many discussions regarding the characterization of ACE2. We are grateful to Kazumi Shiosaki, Julian Adams, Andrew Nichols, and Michael Kuranda for support.
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